Medicare Outline
Medigap Policies
A Medigap policy is a health insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of the Medigap policy must clearly identify it as "Medicare Supplement Insurance."
A Medigap policy must be one of the standardized policies so you can compare them easily. Each policy has a different set of benefits. In addition, any standardized policy may be sold as a "Medicare SELECT" policy. Medicare SELECT policies usually cost less because you must use specific hospitals and, in some cases, specific doctors to get full insurance benefits from the policy. In an emergency, you may use any doctor or hospital.
Outline of Medicare Supplement Coverage
(Benefit Plans A-N)
Medicare Supplement Insurance can be sold in only these standard plans. This chart shows the benefits included in each plan. Every company must make available Plan "A". Some plans may not be available in your state as indicated below.
Y = Plan covers 100% X = Plan doesn't cover % = Amount the plan covers
| A | B | C | D | F* | G | K | L | M | N | |||
| Part A Coinsurance and Hospital Costs | Y |
Y |
Y |
Y |
Y |
Y |
Y |
Y |
Y |
Y |
||
| Part B Coinsurance / Copays |
Y |
Y |
Y |
Y |
Y |
Y |
50% |
75% |
Y | Y | ||
| Blood (First 3 pints) | Y |
Y |
Y |
Y |
Y |
Y |
50% |
75% |
Y | Y | ||
| Part A Hospice | Y | Y | Y | Y | Y | Y | 50% | 75% | Y | Y | ||
| Part A Deductible | X | Y |
Y |
Y |
Y |
Y |
50% |
75% |
50% | Y | ||
| Skilled Nursing Facility | X | X | Y |
Y |
Y |
Y |
50% |
75% |
Y | Y | ||
| Part B Deductible | X | X | Y |
X | Y |
X | X | X |
X | X | ||
| Part B Excess Charges | X | X | X | X | Y |
Y | X |
X |
X | X | ||
| Foreign Travel Emergency (Up to Plan Limits)** |
X | X | 80% |
80% |
80% |
80% |
X |
X | 80% | 80% | ||
| Out of pocket Limit | $5.880 | $2.940 | ||||||||||
Notes:
|
||||||||||||